Planning Ahead

The end of medicine. Ahhhhh. Granted, it was better than surgery, but a 12 week rotation is just not cool. My attention span is definitely not long enough for that. Plus, it leaves me utterly exhausted. Next year's M3's will have a better time. They will only get 8 weeks of medicine and surgery, then 6 weeks of electives. But I guess the good thing is that if all goes according to plan I'll be an M4!!!! Tomorrow is senior planning day and I.CAN'T.WAIT. I've officially decided to not to an away rotation and will try to get the 4th year over with as soon as possible. It's not a residency strategy, just more of a I-need-to-move-out-of-the-house-asap-in-order-to-preserve-any-sanity-I-have-left. I want to take the least painful rotations and get the required stuff done. That's the one downside of picking pathology: all of the M4 courses are electives. But I'll manage, it'll be awesome. I'm so excited about tomorrow. Mainly because I don't have clinical duties and get to see some of my friends that have been on opposite rotations.

Oh, and may I mention that i'm PUMPED about my ob/gyn group? I think the only thing that could make it better if my medicine partner was in Group 5 as well. But I've got HemeOnc Doc and Speed Demon on my team. Bomb-diggity. We start on REI which I heard is super easy. I'll be interested to see the rotation schedule I get, esp. when I have L&D nights. But I don't have much going on in march so it'll be more for my own info than anything else. I hope I get to see some wicked tumors. And if I get to TOUCH a teratoma, omg I may just pee myself!

The thing that got under my skin the most was the whole "you should REALLY consider medicine" statements. I know it's odd for someone to be so decided on something so early in 3rd year, but honestly I'm a person that knows what I like and knows what I want. So as flattering as it SHOULD be, I just get defensive and put off. I like the basic science behind diseases. I like the disease states. I don't like treatment plans. Or what study should I order. Or what complication will I need to look out for with this medication. Just not my cup of tea. I'm so pumped that people want to do that. but not me. I don't think anyone will try to get me on Ob/Gyn or Peds. They'll be like "go away". haha.

But all in all, I enjoyed medicine okay. I think if I didn't like path, I could do medicine. It would be a job, and not something I LOVED. But I could do it.

well, since I have been on Q4 call, have had no social life, and my love life is drier than the Mohave desert, I think that's all I have to talk about. I've started wading my way through USMLE world qbank and hopefully will get some good study time during L&D.My Step 2 CK date is June 24 so I'll have to get some serious knowledge into my head!

Ok, I'll Say It...Who dat.

So I watched the superbowl, and all I have to say is that I wish I could have seen my brother's face when the Saints won the 44th superbowl. He has been a Saints fan all his life and I know he must have been so excited. Although the fact that the Saints made it to the superbowl and WON makes me a little leery of the apocalypse.

I was however very disappointed by the superbowl commercials. I think budgets must really have been that bad this year. I think the winner will be Doritos. My favorite is the guy telling the dog he has to speak for a dorito, and the dog goes up behind the man, puts on the shock collar, barks so the guy gets shocked, and then gets the whole bag for himself. I really laughed at that one. And Bud Light had just...confusing ones. I just didn't get them. And the google one was full out cheesy and sappy.

I have a little under 3 weeks until I finish my internal medicine rotation and I.AM.PUMPED. It really does not float my boat as a medical specialty. I however LOVE my team (well, the scutting  isn't my favorite, but the intern who does it is really nice so I'll just look over that part). The M4's are hilarious and my partner makes my day. Even though I don't think she knows how to take me half the time, I've really enjoyed working with her and she puts up with my little temper tantrums throughout the day.

So tomorrow will be my first day off since starting my rotation on the first. I need it like woah, but unfortunately it also comes with a test. Alas. Also, I'm starting to really think about 4th year schedules and away rotations. I'm still wavering, but I'm leaning toward not going on any away rotations merely for the fact that trying to plan one gives me a migraine.

Well, on that note I'm going to procrastinate and then go to Saigon for some pho!

Rue!

So I'm on general medicine ambulatory. I guess it could be worse. Bestest thing: 3 day weekends. Oh yes, I said THREE DAY MOTHER &%#@!ING WEEKEND!

Fellow 3rd years will know why I'm so excited. But don't worry, I'll be paying my dues soon on VA medicine wards.

So, my epic blog post will not be so epic basically because what would be epic isn't happening anymore. Basically, I mentioned to my dad I was planning on getting a dog, he got mad and started being all "MY HOUSE" and "NO DOGS IN MY HOUSE" and blah which made me mad. I'm 25 and I don't need no house rules. Well, I planned on moving out but after about a week of my mom crying I decided to compromise with her. I'll be getting done with my 4th year as quickly as possible, which means an April finish. So as SOON as I am done (I'm talking May 1st), I'll be going to whatever town holds the institution that I match at and I move. I'll fly back for graduation, but I'm OUT. DONE. Plus, she forks up the money for any kind of dog I want. She agreed. So I guess I'll be stuck here for another year. But I get to move out earlier than intended (may instead of late june). So my advice for anyone intending on moving in with parents: Don't. Looking back it would have been worth all the loans. It was just once I was in i could never get back out. Ugh. Live and learn.

So I'm super pumped about doing next year schedules. I'm planning on doing a July path month (even though Momma Medschool advised against it) because I want to do an away rotation. I'm very nervous about getting it at the place I want, so I'm trying to leave as much open months as I can. So that'll leave Aug, Sept for away before interviews. I'm thinking of an Oct internal medicine month, but a lot of programs I'm looking into do late Oct interviews. So maybe I'll talk to ColorectalSurgeon to be and see if she wants to do the medicine rotation in feb. I'm just hoping I get the rotations when I want. I'm not looking into doing too many freebie classes (granted, 2 Path months + 1 away rotation=1 elective left) but maybe the computers in medicine or something either Nov or Jan so I'll still be free to do interviews. I don't know, I'll have to play with that. And then probably scramble to finish up a bunch of requirements before April.

Speaking of Medicine, I'm totally pumped about my VA ward. I'll have a super awesome partner (who apparently I'll have to be fighting for a path spot.) and an awesome M4 (FABULOUS) and I heard our intern is great and our attending is awesome. So i'm excited! maybe i'll FINALLY have a good medicine experience. Or get out before 6 pm every day.

So one good story that I've recently collected: I was doing clinic and I walk into a patient's room. Both her and her friend/cousin/sister were in the room, BOTH on their cell phones. So I was like "hi mrs. so and so. I'm going to talk to you before the doctor gets in, is that ok?" She looks at me then turns her attention back to her conversation and says "yeah, so how you been?". okay... So I go back out and talk to the doctor. Basically said both of them were on the phone and I was not comfortable telling his clinic patient to hang it up. So he said he'd take care of it. I heard him walk into the room and say "OKAY! PUT THE CELLPHONES AWAY!"

As bon qui qui would say: Rue! (rude. haha)

Saying Our Goodbyes

I think within the past week I've had to do some of the hardest things I've ever had to do.

I had to say goodbye to my dog of 16 years. I've gotten better about talking about it, but it still makes me tear up. If you're ever around me and see me tear up out of the blue, you know I'm thinking about my dog. She was old. And senile. She couldn't hear or see. She had peed on herself while asleep. She spent the last few nights of her life crying as if she was in pain. She had been my baby for the past 16 years. So on the first of two whole days I got off from medicine, I took her to the vet. I won't go more into it, but I never left her. I held her head in my hands and still pet her even after her heart stopped. I even cried in public. I miss her every day. I come home and don't see her. Today when I got home from the store I called for her to take her out (it was one of my routines) but then I remembered. It's so hard, but something I knew would come one day. I just hoped that she'd just never wake up one day instead of having to hold her and watch as she took her last breath. What's worse was that I wanted to scream "I changed my mind! put her back! bring her back!" but I knew I couldn't. It was final. It was done. She was gone.

In with that whole goodbye theme my life has recently taken, I also had to give back sweet precious little kitty. Mainly because Gryffin has spent most of his days trying to murder her. We found out that spraying him down with water was the only way to get him off her. So back she had to go. I'm really sad but I know it's better for her. I really did want to keep her. She was so so so sweet.

So really, the past week has really sucked for me. Not only because of my overanxious partner (granted my eval from my attending was surprisingly positive. I was just happy the word "slacker" was never mentioned) but because I've lost 2 animals in the past week. I just hope that christmas time will be pleasant. I know I need the time off just to collect myself and sleep and just be normal. Medicine really sucks. I think it actually sucks worse than surgery! Luckily my time on blue medicine will end friday at 5 pm.

Speaking of sucky hours, I need to get ready for bed. Got to be up early to pre-pre round.

Gunners and the Rules of Dating

Does anyone remember the beginning of med school, where we were warned of gunners and learned that it carries a very negative connotation? Let's review.
Gunner: A person who is competitive,overly-ambitious and substantially exceeds minimum requirements. A gunner will compromise his/her peer relationships and/or reputation among peers in order to obtain recognition and praise from his/her superiors.

My current partner tends to fit this discription. Now, I'm not saying he's an ass. He's actually really nice and I find it easy to get along with him. And I did confront him on 1. his reputation that is quickly turning toward gunner and 2. the elevator situation. He basically said that he's not "gunning" and that people can think whatever they want. Also, the elevator situation was a misunderstanding. But he thanked me for letting him know. Because honestly, I'm going to tell you once and leave it.

Some Evidence that supports the assumption of gunner:
1. he currently has 5 patients. I have 3. I offered to pick up another, and the resident told me that it would be too much, and to not do it. It was better to know 2-3 patients well than more and not so well. But I don't understand why he feels the need to have so many. Why can't we have the same number?
2. He stays behind and tells me to go home and he'll "wrap it up". Most of the time I don't care. But when the resident says "You're carrying the list" or "you're going to make a great intern" it causes me to worry that I am being outshined, even though I'm doing exactly what I was told to do. And even though I want to do path, it doesn't mean I don't want to do my job and carry my weight as well.
3. The hovering. Maybe that's more of a pet peeve thing, but the looking over the shoulder while you write notes. Or "dont' forget to put down renal consult". Or even looking through the papers I'm holding IN MY HAND to "make sure the resident note wasn't in the stack".

Bottom line: no one wants to work with him. He's gotten a bad rap amongst students. Maybe the gunners do get the better recs and maybe his eval will say "awesome hard worker, great student, knows everythign" and mine will say "average", but the fact that I haven't heard one person want to be his partner on VA is concerning. I would hate if anyone thought i was a gunner. Or even worse a slacker. I think i would honestly cry if I found out NO ONE wanted to be my partner. I would just think with the feedback i gave him he would have calmed down some. Seems like it just made him worse. In a way I'd like a resident to tell him that he needs to cool it. But i know that won't happen. I just dont' want a bad evaluation myself because I seriously feel like I'm being outdone.

Speaking of bad evaluations, how about we talk about all the things NOT to say to a girl you've recently met and/or started showing interest in, shall we?
1. Don't ask "what does it take to get into your pants" 30 min after we start texting each other. it's a quick road the the "do not respond" list.
2. don't text me with your random thoughts or to wish me a good call. As endearing as some people may find this, it annoys me. stop.
3. Don't start talking to me and immediately tell me you're into a "no strings attached f-buddy relationship" or tell me you're not into monogamy or having kids. I mean, seriously?

So yeah, that sums up the last few days. I still hate medicine, and I hate not having a day off even more. What's worse is I'll be post call the day of my test. Can't wait to see what that grade is going to be. Speaking of post call, I'm off to bed.

M3 Progress Note Blue Medicine

25 y/o WF presents to ER with bilateral self mutilation of the wrists c/o feelings of dispair and frustration s/p 2 weeks on internal medicine service with no day off. Denies CP, SOB, N/V/D, NS, F/C
ROS: + insomnia, sleeplessness, decreased appetite, weakness, headache. otherwise negative.
Vitals: Tm: 97.6 HR 85 RR 18 (because it's always 18) BP: 112/68
PE: Gen: WDWN clearly distressed with a wild look to her eye resembling a caged animal, labile mood
CV: RRR no MRG
Lungs: CTAB no WRC, good air movement
Abd: s/nt/nd NABS no HSM noted
Ext: MAEW.
Neuro: PERRL, EMOI, CN II-XII intact, reflexes 2+
musculoskeletal: no atrophy, 5/5 movements in all limbs
GU: no dysuria, hematuria, oliguria
Endocrine: no heat/cold intolerance, hyperphagia, nocturia, polyuria
Psych: labile mood noted

Plan: 1. CT head due to headache and depressed mood r/o tumor
2. EKG
3. Chemistry, CBC, CXR
4. consult vascular and plastic surgery.

Don't be surprised to see this in the UMC system anytime soon. Medicine sucks. I mean, I see how some people like it. But not me. Rounding on people 3 times a day, updating the list several times, ordering test after test, changing someone's fluids from NS to 1/2 NS, adding potassium, waiting for the CBC to come back, it's so...detailed and micromanaged. I just don't have the patience for it. And the prescriptions. I hate pharmacology. No matter the setting. And medicine is all about some, well, just that. medicine. yuck.
2 more weeks till christmas. My first day off is thursday, and I get to spend that putting my dog down because it's the only time I have. so yeah, I can do this, right? Then I'll only have 1 month of house medicine ever and then never again. Why can't I be one of those people who loves everything, instead of disliking it all?

Yeah, completely set on pathology. now to just make up my mind where I want to do residency...

Easier Said Than Done

So project new kitten isn't going so well. I was prepared for the hissing and growling from Gryffin. I wasn't prepared for catatonic kitty depression, personality changet from best friend to antisocial doesn't want anything to do with anyone, or go up to people and instead of being friendly start biting for no reason. So we're trying to see if I can help out my Fashionista friend by finding kitty a good home. We've come close twice. One couldn't because her roomate is allergic. Apparently nosebleeds are associated with kitten dander? Didn't learn about that one in immunology. And the second one, his wife basically came up with a list of excuses so he can't take her either. Both fell absolutely in love with the kitten. She is adoreable, sweet, and very VERY cute. But I have to say my first priority is Gryffin and he's just absolutely miserable. It breaks my heart. If we can't find a home we may just keep her and make her outdoor/indoor kitty.

Aside from feline household drama medicine, well medicine blows. I don't want to do that for a living. Studying the molting patterns of penguins in the south pole sounds like a better plan to me. I definitely realized I don't enjoy patients at all. I don't like the questions and the explaining or the complaining. You're in the hospital because we're trying to make you better. Not like you're going to do anything about it after you go home anyway but at least we're trying. So basically unless I somehow 1. change my mind 2. decide neuro doesn't still give me PTSD or 3. I can handle surgery on an OBGYN basis then I'm doing pathology. For realz. No questions, no medicines, no notes. My idea of a perfect job. Plus 8-5 days, at home call, and no weekends. Win. Also, I won't be responsible for calling up some stupid medical records at some office clinic just to get some voicemail recording on how the lady that does medical records is busy. I mean, I did medical records for 4 years. I always answered calls. And at least my stupid recording would have included "If you wish to fax a request, our number is blah blah blah, blah blah." Instead of me leaving some stupid voicemail for you to call me back ASAP (luckily I spared her the thought of "i'm post call and would like to go home. this number is separating me from my bed and it could end badly for you if I ever meet you in real life) just to wait 20 min for NOTHING. So I search more, get what looks like a fax number, and just send it. If you're going to have voicemail, but down pertinent things LIKE PHONE NUMBERS.

Honestly, hasn't nature found a new way to employ natural selection? Now the dumb people are just breeding together causing a new super breed of moron.

Easier said than done, I suppose.

Upside Down

My Fashionista friend brought over a very cute black and white kitten for me today. I took her straight to the bathroom for her "safety room" so she can get adjusted and get a vet visit in. Gryffin went from "hey what's going on" to "HEY! WHAT THE HELL.IS.GOING.ON". Needless to say, he went from a confused/curious to pissed. Very quickly. He bit me when I picked him up (he never does that-shows you the degree of angry he is currently occupying) which is usually his favorite thing ever. Right now he's on the other couch glaring at me. He's spent the majority of the day outside the bathroom staring down the door. When I'm in the bathroom playing/bonding with kitten (to be later named. I think she's a girl so suggestions welcome!) he sits outside and occasionally growls. It's actually really funny to me. What was even funnier was when my parents got home. the kitten heard my dad and started growling herself. Priceless!

So I'm doing the introductions slowly. I can't really put them in the same room until vet on Tuesday (kitten appears to have tapeworms. Don't want Gryffin getting it). So hopefully he'll get used to the idea/smells by then. Kitten seems to be doing just fine. She's a little skiddish, but took to the litter pan immediately (yay!) and to her food bowl. She doesn't like toys too much-she prefers fingers. And she's gotten close to meeting the squirt bottle as she likes to attack and bite legs.

So that's the newest and most exciting thing. Thanksgiving went well in a very crowded way. I got to talk to my cousin's brother in law for a while. We talked on healthcare and the justification of the FDA. It was good, I didn't get overstimulated with all the company. Now I'm just really enjoying my break before 3 straight weeks of house medicine. Not entirely looking forward to it. I'm apprehensive about my partner. I woudln't be surprised if I end up going in early monday morning because he won't want to use the "our break officially ends at 8 am" cop-out. Ugh.

I'll have to post pics as soon as I get them. I'm sure the cat drama will be occupying my time for the next few days. Poor Gryffin-I realize his world has been turned upside down. As well as my official declaration that yes, yes I am now the cat lady.